Provider Demographics
NPI:1902837602
Name:CHINITZ, LYNN R (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNN
Middle Name:R
Last Name:CHINITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 N. MILLS ST.
Mailing Address - Street 2:
Mailing Address - City:NYACK
Mailing Address - State:NY
Mailing Address - Zip Code:10960
Mailing Address - Country:US
Mailing Address - Phone:845-446-1100
Mailing Address - Fax:845-446-4581
Practice Address - Street 1:244 WESTCHESTER AV.
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604
Practice Address - Country:US
Practice Address - Phone:914-946-5390
Practice Address - Fax:914-681-2906
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1776762085R0205X
NY1775792085R0205X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085R0205XAllopathic & Osteopathic PhysiciansRadiologyRadiological Physics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01424657Medicaid
NY1424657Medicaid
NY1424657Medicaid
NY01424657Medicaid
NY53H671Medicare PIN